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The conclusion of the provincial labor ability appraisal is the final conclusion, and the new illness is caused by the work-related injury and enjoys the medical treatment of the work-related injury.
According to Article 26 of the Regulations on Work-related Injury Insurance, the appraisal conclusion of the labor ability appraisal committee of the province, municipality directly under the Central Government and autonomous region is the final conclusion and shall not be dissatisfied with the parties.
If an employee discovers a new illness after the provincial labor ability appraisal, the illness is not a work-related injury according to the provisions of Article 30, Paragraph 5 of the Regulations on Work-related Injury Insurance. If it is caused by a work-related injury, you can enjoy the medical treatment of work-related injury, and if it is caused by work-related injury, it shall be handled according to the medical insurance measures.
Regulations on Work-related Injury Insurance
Article 26 If the unit or individual applying for appraisal is not satisfied with the appraisal conclusion made by the labor ability appraisal committee at the districted city level, it may submit an application for re-appraisal to the labor ability appraisal committee of the province, autonomous region or municipality directly under the Central Government within 15 days from the date of receipt of the appraisal conclusion. The labor ability appraisal conclusions made by the labor ability appraisal committees of provinces, autonomous regions and municipalities directly under the Central Government are the final conclusions.
Article 30 Employees who are injured in accidents or suffer from occupational diseases due to work shall enjoy medical treatment for work-related injuries.
Employees who are injured at work shall seek medical treatment in a medical institution that has signed a service agreement, and in case of emergency, they can first go to the nearest medical institution for first aid.
**If the expenses required for work-related injuries meet the requirements of work-related injury insurance diagnosis and treatment items, work-related injury insurance drug lists, and work-related injury insurance hospitalization service standards, they shall be paid from work-related injury insurance**. The catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs, and the hospitalization service standards of work-related injury insurance shall be prescribed by the social insurance administrative department in conjunction with the health administrative department, the food and drug supervision and administration department and other departments.
The food subsidy for the hospitalization of the employee for the work-related injury, as well as the transportation, accommodation and accommodation expenses required for the work-related injury employee to seek medical treatment outside the co-ordination area shall be paid from the work-related injury insurance, and the specific standard of payment shall be stipulated by the people of the co-ordination area.
Injured employees are not entitled to medical treatment for work-related injuries and shall be dealt with in accordance with the basic medical insurance measures.
If the work-related injury employee goes to the medical institution that has signed the service agreement to carry out the work-related injury**, if it meets the requirements, it shall be paid from the work-related injury insurance**.
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One year after the conclusion of the labor capacity appraisal is made, if the injured employee, the employer or the social insurance agency believes that the disability has changed, it may apply to the labor ability appraisal committee at the districted city level for a review and appraisal of the labor ability.
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The appraisal results from the provincial appraisal center are the final conclusion!
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Legal analysis: An application for re-appraisal may be submitted to the labor ability appraisal committee of the province, autonomous region, or municipality directly under the Central Government within 15 days from the date of receipt of the appraisal conclusion.
Legal basis: "Regulations on Work-related Injury Insurance and Deficiency Insurance" Article 26 If the unit or individual applying for appraisal is not satisfied with the appraisal conclusion made by the labor ability appraisal committee at the districted city level, it may submit an application for re-appraisal to the labor ability appraisal committee of the province, autonomous region or municipality directly under the Central Government within 15 days from the date of receipt of the appraisal conclusion. The labor ability appraisal conclusions made by the labor ability appraisal committees of provinces, autonomous regions, and municipalities directly under the jurisdiction of Tankong are the final conclusions.
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If you are not satisfied with the results of the provincial work-related injury appraisal, you shall not apply for the work-related injury appraisal again, and the conclusion of the provincial-level labor ability appraisal shall be the final conclusion. Those who are not satisfied with the conclusion of the municipal labor ability appraisal may submit an application for re-appraisal to the labor ability appraisal committee of the province, autonomous region or municipality directly under the Central Government within 15 days from the date of receipt of the appraisal conclusion.
[Legal basis].Article 26 of the Regulations on Work-related Injury Insurance.
If the unit or individual applying for the appraisal of the scattered hole is not satisfied with the appraisal conclusion made by the labor ability appraisal committee at the districted city level, it may submit an application for re-appraisal to the labor ability appraisal committee of the province, autonomous region or municipality directly under the Central Government within 15 days from the date of receipt of the appraisal conclusion. The labor ability appraisal conclusions made by the labor ability appraisal committees of provinces, autonomous regions and municipalities directly under the Central Government are the final conclusions.
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Legal analysis: An application for re-appraisal may be submitted to the provincial, autonomous region, or municipality labor ability appraisal committee within 15 days from the date of receipt of the appraisal conclusion.
Legal basis: Regulations on Work-related Injury Insurance Article 26 If the unit or individual applying for appraisal is not satisfied with the appraisal conclusion made by the labor ability appraisal committee at the districted city level, it may submit an application for re-appraisal to the labor ability appraisal committee of the province, autonomous region or municipality directly under the Central Government within 15 days from the date of receipt of the appraisal conclusion. The conclusion of the labor ability appraisal made by the labor ability appraisal committees of provinces, autonomous regions and municipalities directly under the Central Government shall be the final conclusion.
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1) If the injured employee is not satisfied with the conclusion of the disability level, the correct approach should be to go through the bottom-up review procedure to ensure the fairness and reasonableness of the appraisal work. That is, if the employee is not satisfied with the disability appraisal conclusion made by the Municipal Labor Appraisal Committee, he or she can apply to the Provincial Labor Commission for re-appraisal, and the appraisal conclusion made by the Provincial Labor Appraisal Committee is the final conclusion.
2) Employees who are injured in the workplace cannot file an administrative lawsuit if they are not satisfied with the conclusion of the level of disability, for the following reasons: First, the administrative reconsideration measures clearly stipulate that this situation does not fall within the scope of administrative reconsideration, so it is natural that administrative litigation cannot be initiated. After the promulgation of the Administrative Litigation Law of the People's Republic of China, the Ministry of Labor and Social Security issued the Measures for Administrative Reconsideration of Labor and Social Security on November 23, 1999
Citizens, legal persons or other organizations that are dissatisfied with the disability grade appraisal conclusion made by the labor appraisal committee cannot apply for administrative reconsideration (see Article 5). That is to say, there is no legal basis for citizens or legal persons to file legal proceedings or for the court to accept cases if they are not satisfied with the level of labor ability appraisal. Second, from the perspective of the organization and nature of the work of the labor appraisal committee, it is not a specific administrative act.
Therefore, the appraisal of disability grades is carried out in accordance with the national disability assessment standards, and the labor appraisal committee is a fictitious institution that coordinates the cooperation of labor, health and trade union departments and supports this cause, and the work of the labor appraisal office is specifically organized and implemented. The identification of the level of disability and the degree of dependence on nursing care is a technical conclusion made by the medical expert group based on the injury of the injured employee, and it is to a large extent a technical and career work, not a specific administrative act.
1. What are the criteria for determining work-related injuries?
In any of the following circumstances, an employee shall be deemed to have suffered a work-related injury: he or she is injured in an accident during working hours and in the workplace due to work-related reasons; Injured in an accident while engaged in work-related preparatory or finishing work in the workplace before or after working hours; Injured by violence or other accidents during working hours and in the workplace due to the performance of work duties; suffering from occupational diseases; During the period of going out for work, the person is injured due to work reasons or the whereabouts of the accident are unknown; Injured in a motor vehicle accident while commuting to or from work; Other circumstances that laws and administrative regulations provide shall be recognized as work-related injuries.
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The next step is to apply to the Social Security Bureau for work-related injury benefits, and you need to submit the work-related injury identification certificate, disability appraisal conclusion, medical expense invoice and other first-class information, and then you can reimburse the expenses. If the employer fails to pay social security in accordance with the regulations, this part of the cost shall be borne by the employer, and the employer shall bring the same documents to the employer for reimbursement.
Regulations on Work-related Injury Insurance
Article 17. If an employee is injured in an accident or is diagnosed or appraised as an occupational disease in accordance with the provisions of the Law on the Prevention and Control of Occupational Diseases, the unit to which he or she belongs shall, within 30 days from the date of occurrence of the accident injury or the date of diagnosis or appraisal of an occupational disease, submit an application for recognition of work-related injury to the social insurance administrative department of the coordinating area. In case of special circumstances, the time limit for application may be appropriately extended with the consent of the social insurance administrative department.
Regulations on Work-related Injury Insurance
Article 20. The social insurance administrative department shall make a decision on the determination of work-related injury within 60 days from the date of acceptance of the application for work-related injury determination, and notify the employee applying for work-related injury determination or his close relatives and the employee's employer in writing. The social insurance administrative department shall make a decision on the determination of work-related injury within 15 days of accepting an application for work-related injury determination where the facts are clear and the rights and obligations are clear.
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1.Yes, if there is any objection to the appraisal of labor ability (appraisal of work-related injury and disability), you can apply to the provincial labor ability appraisal committee for re-examination within 15 days from the date of receipt of the appraisal conclusion.
2.According to Article 26 of the Regulations on Work-related Injury Insurance, if an applicant for appraisal is dissatisfied with the appraisal conclusion made by the labor ability appraisal committee at the level of a city divided into districts, it may submit an application for re-appraisal to the labor ability appraisal committee of the province, autonomous region or municipality directly under the Central Government within 15 days from the date of receipt of the appraisal conclusion. The labor ability appraisal conclusions made by the labor ability appraisal committees of provinces, autonomous regions and municipalities directly under the Central Government are final.
3.According to the provisions of Article 16 of the Administrative Measures for the Appraisal of the Labor Ability of Employees Injured at Work, in addition to the materials specified in Article 8 of these Measures (that is, the materials for the first appraisal declaration), the original and photocopy of the initial appraisal conclusion of the labor ability shall also be submitted.
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